Treatment of adult femoral neck fracture is still a great challenge faced by trauma orthopedists. As treatment effects can be infleunced by multiple factors, like age, gender and preoperative physical condition, they may vary with different treatment schemes. Classification of femoral neck fractures plays an important guiding role in choosing a proper treatment scheme and judging the prognosis. The current classic clinical classification systems for femoral neck fractures include Garden, AO/OTA and Pauwels classifications. Since the recent progress in science and technology has put more advanced technologies into clinic application, such as CT, MRI and Digital Subtraction Angiography (DSA), new ways of classification have appeared. However, each classification has its own shortcomings which need to be improved. This paper reviews the research progress in classification of adult femoral neck fractures and their treatment principles.

Objective:To investigate whether knee osteoarthritis has an impact on the patient′s depression and whether it′s progression will affect the patient′s depression, and to provide a reference for clinical work.Methods:Patients diagnosed with osteoarthritis in Dalian Central Hospital from 2016 to 2019 were divided into 4 groups according to Kellgren-Lawrence staging, and the patients were scored on WOMAC scale, AKSS clinical scale, and AKSS. The score of the scale and the score of the HAMD scale were collected and statistically analyzed using SPSS 17.0.Results:χ2 test was used to show that there was no difference in the gender composition of patients in different stages ( P<0.05). The AKSS clinical scale score, AKSS functional scale score, WOMAC scale score and HAMD scale score were statistically analyzed for each stage. The results showed that the average AKSS clinical scores of patients in each stage were as follows: stage Ⅰ: (90.01 ± 8.41) points; stage Ⅱ: (79.98 ± 10.93) points; stage Ⅲ: (71.78 ± 13.64) points; stage Ⅳ: (54.18 ± 12.58) points. The AKSS functional scores were as follows, stage Ⅰ: 100 points; stage Ⅱ: 80 points; stage Ⅲ: 70 points; stage Ⅳ: 45 points; the average WOMAC scale scores of patients in each stage were as follows, stage Ⅰ: (28.69 ± 19.22) points ; stage Ⅱ: (49.43 ± 22.69) points; stage Ⅲ (70.13 ± 24.84) points; stage Ⅳ: (107.79 ± 24.39) points. The average HAMD scale scores of patients in each stage were as follows, stage Ⅰ: (4.89 ± 3.42) points; stage Ⅱ: (7.65 ± 4.20) points; Stage Ⅲ: (9.05 ± 5.03) points; stage Ⅳ: (12.35 ± 5.41) points. The analysis showed that there were significant statistical differences in the scale scores between each period ( P<0.05). There was a correlation between the patient′s depression status and the patient′s age, pain, and joint function, and there were statistical differences ( P<0.05). Conclusions:There is a significant correlation between depression and pain and function in patients with knee osteoarthritis. The progress of the osteoarthritis course will aggravate the patient′s depression state. Conversely, the patient′s depression state can also aggravate the symptoms of osteoarthritis patients and affect the clinical efficacy of the patients.

Objective:To further understand the clinical characteristics of scirrhous gastric cancer (SGC)and clear it definitions. Analyzed the clinicopathologic features and prognosis of patients with SGC and Non SGC(NSGC).Methods:The study included 342 gastric cancer patients who had undergone gastrectomy in the Second Hospital University of South China between May 2011 and May 2018. The SGC was diagnosed by endoscopic, CT, tumor stroma ratio and appearance of surgical specimen clinicopathological characteristics were summarized and compared between SGC patients and NSGC using pearson′s χ2 test or student′s t test. Survival curves were estimated with the Kaplan-Meier method. Patients were matched 1∶1 using propensity score matching, and their overall survival rates were compared. Results:A total of 342 patients with gastrectomy were collected, 49 (14.3%) were diagnosed as SGC. Patients with SGC were younger, later pathological stage lymph node metastases tend to occur than those(NSGC). SGC had a higher total gastric resection rate, easier prone to nerve/vascular invasion and omental metastasis ( P<0.01). The median survival of SGC patients and overall survival at 1, 3, and 5 years after surgery were shorter than NSGC patients, which were independent risk factors affecting the prognosis of patients. Conclusions:SGC can be well defined by endoscopy, CT, TSR and tumor appearance. It is a peculiar solid tumor with poor differentiated, advanced stage and poor prognosis. Future research should focus on how to diagnose SGC earlier and intervene in time.

Objective To compare the image quality of diffusion-weighted MR neurography (DW-MRN) of the tibial nerve and the common peroneal nerve prospectively using different motion probing gradients (MPGs).Methods A total of 21 healthy volunteers underwent DW-MRN at the knee (unilateral imaging) on a 3.0 T magnetic resonance system with unidirectional MPGs.The protocol included anteriorposterior unidirectional,right-left unidirectional,three-directional and six-directional MPGs.The apparent SNR and CNR of tibial nerve and common peroneal nerve were calculated.Three-dimensional MIP images of the nerves were evaluated blindly by two radiologists using a four-point grading scale on basis of entirety depiction and the signal intensity.Significance was determined by using Friedman and paired Wilcoxon tests.Results The SNR of tibial nerves on DW-MRN with anterior-posterior,right-left,three directional and six directional MPGs were 4.17 (2.70-5.65),4.35 (0.47-4.69),3.46 (2.27-4.62) and 3.30 (2.06-4.43),respectively.CNR were 0.61 (0.46-0.70),0.63 (0.36-0.73),0.55 (0.39-0.64) and 0.53(0.35-0.63),respectively.The scores of tibial nerve image quality were 4.0 (2.0-4.0),4.0 (3.0-4.0),2.5 (2.0-3.5),2.0 (1.0-2.5),respectively.Interobserver agreement was good and the Kappa value was 0.69 (P ＜ 0.05).The SNR of the common peroneal nerves on DW-MRN with anteriorposterior,right-left,three directional and six directional MPGs were 3.05 (2.30-4.20),3.05 (2.26-4.34),2.72 (1.84-13.80) and 2.68 (1.87-3.67),respectively.CNR were 0.51 (0.39-0.62),0.51 (0.39-0.63),0.46(0.30-0.86) and 0.46(0.30-0.57),respectively.The scores of the common peroneal nerve image quality were 3.5 (2.0-4.0),4.0 (2.0-4.0),2.0 (1.0-3.0) and 2.0 (1.0-2.5),respectively.Interobserver agreement was good and the Kappa value was 0.70(P ＜0.05).For SNR,CNR and nerve image quality of the tibial nerves and the common peroneal nerves,there were significant differences among different MPGs (x2 =215.01,215.01,60.49 and 182.82,182.82,60.22,respectively,P ＜ 0.05).SNR,CNR and nerve image quality of the tibial nerves and the common peroneal nerves on DW-MRN with unidirectional MPGs were better than those with three-directional and sixdirectional MPGs (Z =-6.90-4.03,P ＜ 0.05).The SNR and CNR of the tibial nerves on DW-MRN with right-left direction were better than those with anterior-posterior unidirectional MPGs (Z =-3.53,-3.41,P ＜ 0.05),but there was no significant difference of image quality between right-left and anteriorposterior directional MPGs (Z =-0.58,P ＞ 0.05).DW-MRN of the tibial nerves with three-directional MPGs was better than that with six-directional MPGs (Z =-3.00,-2.80,-3.92,P ＜ 0.05).There were no significant differences between right-left and anterior-posterior unidirectional MPGs,or between three-directional and six-directional MPGs of common peroneal nerves (Z =-1.94--0.31,P ＞ 0.05).Conclusions DW-MRN has capability to provide three-dimensional visualization of the tibial and common peroneal nerves,and the image quality with unidirectional MPGs is better than that with three or six directional MPGs.